Improving delivery of Bright Futures preventive services at the 9- and 24-month well child visit

Pediatrics. 2015 Jan;135(1):e178-86. doi: 10.1542/peds.2013-3119.


Objectives: To determine if clinicians and staff from 21 diverse primary care practice settings could implement the 2008 Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd edition recommendations, at the 9- and 24-month preventive services visits.

Methods: Twenty-two practice settings from 15 states were selected from 51 applicants to participate in the Preventive Services Improvement Project (PreSIP). Practices participated in a 9-month modified Breakthrough Series Collaborative from January to November 2011. Outcome measures reflect whether the 17 components of Bright Futures recommendations were performed at the 9- and 24-month visits for at least 85% of visits. Additional measures identified which office systems were in place before and after the collaborative.

Results: There was a statistically significant increase for all 17 measures. Overall participating practices achieved an 85% completion rate for the preventive services measures except for discussion of parental strengths, which was reported in 70% of the charts. The preventive services score, a summary score for all the chart audit measures, increased significantly for both the 9-month (7 measures) and 24-month visits (8 measures).

Conclusions: Clinicians and staff from various practice settings were able to implement the majority of the Bright Futures recommended preventive services at the 9- and 24-month visits at a high level after participation in a 9-month modified Breakthrough Series collaborative.

Keywords: collaborative learning; performance measurement; preventive health care; primary care; screening.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child Health Services / statistics & numerical data
  • Child Health Services / supply & distribution*
  • Female
  • Health Promotion*
  • Humans
  • Infant
  • Male
  • Preventive Health Services / statistics & numerical data
  • Preventive Health Services / supply & distribution*
  • United States